title: Identifying and classifying quality-of-life tools for assessing pressure ulcers after spinal cord injury.
abstract: BACKGROUND
  Although pressure ulcers may negatively influence quality of life (QoL) post-spinal cord injury (SCI), our understanding of how to assess their impact is confounded by conceptual and measurement issues. To ensure that descriptions of pressure ulcer impact are appropriately characterized, measures should be selected according to the domains that they evaluate and the population and pathologies for which they are designed.
  
  
  OBJECTIVE
  To conduct a systematic literature review to identify and classify outcome measures used to assess the impact of pressure ulcers on QoL after SCI.
  
  
  METHODS
  Electronic databases (Medline/PubMed, CINAHL, and PsycInfo) were searched for studies published between 1975 and 2011. Identified outcome measures were classified as being either subjective or objective using a QoL model.
  
  
  RESULTS
  Fourteen studies were identified. The majority of tools identified in these studies did not have psychometric evidence supporting their use in the SCI population with the exception of two objective measures, the Short-Form 36 and the Craig Handicap Assessment and Reporting Technique, and two subjective measures, the Life Situation Questionnaire-Revised and the Ferrans and Powers Quality of Life Index SCI-Version.
  
  
  CONCLUSIONS
  Many QoL outcome tools showed promise in being sensitive to the presence of pressure ulcers, but few of them have been validated for use with SCI. Prospective studies should employ more rigorous methods for collecting data on pressure ulcer severity and location to improve the quality of findings with regard to their impact on QoL. The Cardiff Wound Impact Schedule is a potential tool for assessing impact of pressure ulcers-post SCI.
authors.affiliation: Lyndhurst Centre, Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario; and Division of Clinical Pharmacology, Health Outcomes and PharmacoEconomics (HOPE) Research Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
authors.forename: Sander L
authors.initials: SL
authors.lastname: Hitzig
authors.affiliation: Lyndhurst Centre, Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario.
authors.forename: Christina
authors.initials: C
authors.lastname: Balioussis
authors.affiliation: Lyndhurst Centre, Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario; and Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Ethne
authors.initials: E
authors.lastname: Nussbaum
authors.affiliation: Lyndhurst Centre, Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario; and Department of Medicine, Division of Physiatry, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Colleen F
authors.initials: CF
authors.lastname: McGillivray
authors.affiliation: Lyndhurst Centre, Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario; and Department of Medicine and Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
authors.forename: B
authors.initials: B
authors.lastname: Catharine Craven
authors.affiliation: Centre Interdiscipinaire de Recherche en Réadaptation et Intégration Sociale (CIRRIS), Québec, Québec, Canada; and Departement de Réadaptation, Faculté de Médicine, Université Laval, Québec, Québec, Canada.
authors.forename: Luc
authors.initials: L
authors.lastname: Noreau
mesh_terms: D006801:Humans; D003668:Pressure Ulcer / Q000523:psychology*; D011594:Psychometrics / Q000379:methods*; D011788:Quality of Life; D013119:Spinal Cord Injuries / Q000150:complications* / Q000523:psychology